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THE LIGAMENTS OF THE SACRUM The Primary Cause of Low-Back Pain, Part 1 Different generations have used different phrases to describe low-back pain. In the 1940s, it was "Oh, my aching sacroiliac." In the 1950s and 1960s, the slipped disc theory entered a phase of popularity, and the 1980s were the decade of the trigger point. Though the sacroiliac theory passed out of vogue, it was actually a very accurate description of the primary cause of chronic low-back pain. Microtears of the sacroiliac and other ligaments of the posterior pelvis surrounding the sacrum account for the majority of low- back and so-called sciatic pain, but many people are unaware that the sacral area can cause such far-reaching problems. SACRUM ILIOLUMBAR LIGAMENT SACROILIAC LIGAMENTS SACROTUBEROUS LIGAMENT CREDIT: Putz/Pabst: Sobotta, Atlas der Anatomie des Menschen, 22nd edition © 2006 Elsevier GmbH, Urban & Fischer, München WHAT ARE THE LIGAMENTS IN THE SACRAL AREA? The sacroiliac ligaments hold the sacrum to the iliac bones (hence the term sacroiliac ligaments). This junction connects the upper and lower parts of the body, the spine to the pelvis. This connection is pivotal to our low-back and pelvic health, as these ligaments hold together and stabilize the back of the pelvis. They consist of thousands of individual fibers that are deeply layered for nearly two inches. Tears of these ligaments cause low- back, buttock, and lateral hip pain, as well as so-called sciatic pain down into the thigh, lower leg, and foot. The sacrotuberous and sacrospinous ligaments stabilize the lower part of the sacrum; through their attachments to the ischia, they hold the lower sacrum to the bottom of the pelvis. There are also suprasacral ligaments, which are an extension of the supraspinous ligaments in the low back. These small ligaments connect the bony protuberances on the posterior surface of the sacrum that are the remnants of the fused vertebrae that form the sacrum. Tears in these various ligaments can cause low-back pain, buttock pain, and referred pain down the leg. The pain massagetherapy.com—for you and your clients 103